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Diagnosis & Treatment of Male Depression
6 CEUs Big Boys Don't Cry Diagnosis & Treatment of Male Shame and Depression

Section 14
Stress, Shame, & Struggles with Anger

CEU Question 14 | CE Test | Table of Contents | Depression CEU Courses
Psychologist CEs, Social Worker CEUs, Counselor CEUs, MFT CEUs

More than 80 percent of the men who took the Male Stress Survey said they had been physically violent at some point during their lives-some while at war, some while in love, some when at play, and some in self-defense. Why is male conflict so common? It's not just testosterone. I suspect it's also in part because of the internal conflicts males must live with. Their inner fights become outer fights. They say they have mixed feelings about religion, marriage, monogamy, and the work ethic. Many, in fact, said that they had mixed feelings about "everything!"

Chronic male anger, then, may be due in part to chronic male agitation about conflicting demands and unresolved attitudes. It may also, however, be overdetermined-that is, it may have more than one cause. Male aggression, overt or covert, may also be due to the following:

1. A rehearsal effect. During their younger years, boys fight. They fight for fun, playing war. They fight for their school, playing sports. They fight for their girlfriends, playing around. Now, as adults, they await the "real thing."
2. A modeling effect. Men see men fight in the sports arenas, in films, on television, as police, as firefighters. They have seen violence "work."
3. A releasing factor. Many men experience a surge of aggression when they drink alcohol, which is referred to as a releasing factor. Aggression that they can easily inhibit when they are sober becomes disinhibited when they are intoxicated. If their drinking is the result of being aggravated in the first place, the aggression released is likely to be particularly volatile.
4. A rechanneling factor. As unacceptable as aggression may seem to be, many men have learned that dependency needs, fears, some sexual impulses, sadness, and even love are less acceptable. Tension from these other areas may be rechanneled into the expression of anger or aggressiveness. Homophobia, for example, may be explained as a man's fear of his own more "feminine" emotions being rechanneled into a rage reaction to homosexuals.
5. A reaction result. Suppressing and repressing reactions to frustration will not succeed forever. The more a man denies his angry impulses, the more indirectly those impulses are likely to be building force. If he is not recognizing his feelings and using up the adrenaline in a constructive way, he is likely to react rather than act on his feelings.

Chronic anger, like all long-term stresses, wears and tears on psychological and physical resources. It leaves little energy for giving out love, little room for taking in love, and little motivation for making love. Therapist Terrence Real in How Can I Get Through to You? (Reconnecting Men and Women) calls it "toxic masculinity"-and warns that it leads to "the legacies of drinking, womanizing, depression, and fury." So chronic anger not only increases male stress, it also interferes with avenues of stress reduction.
- Witkin, Georgia, The Male Stress Survival Guide, NewMarket Press: New York, 2002.

Personal Reflection Exercise Explanation
The Goal of this Home Study Course is to create a learning experience that enhances your clinical skills. Thus, space has been provided for you to make personal notes as you apply Course Concepts to your practice. Affix extra Journaling paper to the end of this Course Content Manual. We encourage you to discuss the Personal Reflection Journaling Activities, found at the end of each Section, with your colleagues. Thus, you are provided with an opportunity for a Group Discussion experience. Case Study examples might include: family background, socioeconomic status, education, occupation, social/emotional issues, legal/financial issues, death/dying/health, home management, parenting, etc. as you deem appropriate. A Case Study is to be approximately 150 words in length. However, since the content of these “Personal Reflection” Journaling Exercises is intended for your future reference, they may contain confidential information and are to be applied as a “work in progress”. You will not be required to provide us with these Journaling Activities. Only the Test is to be returned to the Institute.

Personal Reflection Exercise #6
The preceding section contained information about male stress and struggles with anger. Write three case study examples regarding how you might use the content of this section in your practice.

Peer-Reviewed Journal Article References:
Charak, R., Eshelman, L. R., & Messman-Moore, T. L. (2019). Latent classes of childhood maltreatment, adult sexual assault, and revictimization in men: Differences in masculinity, anger, and substance use. Psychology of Men & Masculinities, 20(4), 503–514.

Gebhard, K. T., Cattaneo, L. B., Tangney, J. P., Hargrove, S., & Shor, R. (2019). Threatened-masculinity shame-related responses among straight men: Measurement and relationship to aggression. Psychology of Men & Masculinities, 20(3), 429–444.

Lair, E. C. (2020). Gender influences the feedback anger and disgust provide about construal use in likelihood judgments. Psychology of Men & Masculinities, 21(3), 401–415.

Online Continuing Education QUESTION 14
What are five possible causes of male aggression whether overt or covert? Record the letter of the correct answer the CE Test.

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